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It is encouraging that the popular BBC’s Victoria Derbyshire programme, which focuses on news and current affairs, chose to devote a feature recently to the often hidden trauma of suffering perineal tears caused by childbirth. As clinical negligence solicitors, we frequently hear from women that their symptoms have been exacerbated by poor care, delay in diagnosis and sadly, lack of awareness about the problem.
The programme featured interviews with women who have been affected by perineal tears and highlighted the devastating impact that their injuries have had on their lives. Symptoms can include pain, incontinence (both urinary and faecal), and pain and difficulty having sex. Evidence suggests that around 85% of women have some form of tear during their first vaginal childbirth and according to the British Journal of Gynaecology (BJOG) the number of women suffering severe third and fourth degree tears increased from 2% to 6% between 2000 and 2012. Part of this rise can be explained by better diagnosis, which is of course positive, and the increase in women giving birth in later life and heavier babies being born is said to also have contributed to the increase.
Suffering a perineal tear in childbirth is not negligent of itself, as it is a recognised complication of child birth. However, we often hear from our clients that they have suffered tears which are severe and require urgent repair which have either gone undiagnosed following the birth or been misdiagnosed as a less severe tear. Unfortunately, this can lead to repair and reconstruction surgery being less successful than it otherwise would have been, had earlier intervention occurred.
The programme featured an interview with a specialist perineal midwife, who highlighted her belief that medical professionals require more training on how to repair tears. She described the current level of care as “quite patchy” and not standardised. It is positive that she has started her own training course on perineal suturing for midwives, junior doctors and students. In addition, the Royal College of Obstetricians and Gynaecologists and the Royal College of Midwives began a collaborative project earlier this year to work together to standardise practice relating to the prevention of third and fourth degree perineal tears, the ultimate aim being to reduce the occurrence of these. Ranee Thakar, Clinical Lead of the project and Consultant Urogynaecologist at Croydon Health NHS Trust noted that
“…. through improved training, raising awareness of the long term impact of severe tearing and standardising practice among doctors and midwives, we are confident that we can reduce rates significantly in the UK”.
It is crucial that the stigma around perineal injury during childbirth is removed and it is heartening that a well-known BBC current affairs programme with a wide reach has chosen to cover this story. The feature focused on the fact that many women sadly suffer in silence as they are unsure what symptoms to expect after giving birth, often wrongly informed that what they are suffering is a normal consequence of vaginal delivery. Understandably, many women are embarrassed and find it difficult to discuss their symptoms. The programme reported that when women do seek help, they can sometimes be placated or told by their doctor that their symptoms are in some way to be expected and will improve, an experience that is sadly borne out by the accounts given by clients who come to us.
If you have experienced a perineal tear during childbirth and are concerned about the treatment you have received, you can contact our clinical negligence team at email@example.com or by calling 020 7814 1200.
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